1) The study examined 500 extracted teeth to identify patterns in pulp chamber and root canal anatomy.
2) Laws were proposed based on observations, including that the pulp chamber is centered at the CEJ, the walls are concentric to the tooth, and the floor is a darker color than walls.
3) Root canal orifices were always found at the junction between the darker floor and lighter walls, located at angles in the floor.
4) These laws aim to help clinicians more reliably locate pulp chambers and root canals, especially in teeth with complex anatomy or prior restorations.
Bonding to Enamel and Dentin Bonding to Enamel and DentinStephanie Chahrouk
1. Bonding agents allow for placement of aesthetic restorations like composites by bonding to enamel and dentin. Developments in bonding agents and composite materials as well as increased focus on aesthetics have boosted adhesive dentistry.
2. Bonding techniques minimize removal of tooth structure, manage sensitivity, reduce microleakage, and expand aesthetic options. Conditioning enamel with phosphoric acid increases surface area for bonding through resin tags.
3. Dentin requires both acid conditioning to remove the smear layer and expose collagen and priming to promote resin infiltration into demineralized dentin. Maintaining a moist environment is important for optimal dentin bonding.
This document discusses open apex and apexification treatment. It defines open apex as an immature root with incomplete development and a large apical opening. Treatment depends on pulp vitality - apexogenesis aims to encourage continued root development if the pulp is vital, while apexification induces apical closure if the pulp is necrotic. The document outlines the stages of root development, causes of open apex, complications, diagnosis, and various treatment options and materials used for apexogenesis and apexification such as calcium hydroxide, MTA, and Biodentine.
Techniques of direct composite restorationMrinaliniDr
Techniques of the direct composite restoration. Includes different instruments, matrix system, wedges, bevel, etching, bonding, and placement of composite along with finishing and polishing and clinical management
The document describes the altered cast technique, which is a modification of the functional impression technique used in removable partial dentures. It involves making a functional impression to capture the displaced shape of the residual ridge under load. The edentulous area is then cut out from the original master cast. The framework and functional impression are seated on the modified master cast. Stone is poured into the impression to create an altered, or corrected, cast reflecting the displaced ridge shape under load. This ensures uniform support of the denture base in the functional form of the residual ridge.
Biomimetic materials used in conservative dentistry & endodonticsTirthankar Bhaumik
This document discusses biomimetic materials used in conservative dentistry and endodontics. It begins by defining biomimetics as materials and processes that mimic nature. Glass ionomer cement is highlighted as a key biomimetic material that acts as a dentin substitute. It has properties similar to dentin, such as elastic modulus and thermal expansion coefficient, and adheres chemically to tooth structure. The document outlines various uses of glass ionomer cement in restorations, luting, liners, and as a root canal sealer. While modifications have improved some properties, its strength and wear resistance remain lower than natural dentin. Overall, the document examines how glass ionomer cement biomimically replaces lost dentin structure for
This presentation gives a brief description of the clinical features and causes of gummy smile conditions , their clinical and differential dignosis , as well as the different treatment methods that may be used to correct these problems .
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
Bonding to Enamel and Dentin Bonding to Enamel and DentinStephanie Chahrouk
1. Bonding agents allow for placement of aesthetic restorations like composites by bonding to enamel and dentin. Developments in bonding agents and composite materials as well as increased focus on aesthetics have boosted adhesive dentistry.
2. Bonding techniques minimize removal of tooth structure, manage sensitivity, reduce microleakage, and expand aesthetic options. Conditioning enamel with phosphoric acid increases surface area for bonding through resin tags.
3. Dentin requires both acid conditioning to remove the smear layer and expose collagen and priming to promote resin infiltration into demineralized dentin. Maintaining a moist environment is important for optimal dentin bonding.
This document discusses open apex and apexification treatment. It defines open apex as an immature root with incomplete development and a large apical opening. Treatment depends on pulp vitality - apexogenesis aims to encourage continued root development if the pulp is vital, while apexification induces apical closure if the pulp is necrotic. The document outlines the stages of root development, causes of open apex, complications, diagnosis, and various treatment options and materials used for apexogenesis and apexification such as calcium hydroxide, MTA, and Biodentine.
Techniques of direct composite restorationMrinaliniDr
Techniques of the direct composite restoration. Includes different instruments, matrix system, wedges, bevel, etching, bonding, and placement of composite along with finishing and polishing and clinical management
The document describes the altered cast technique, which is a modification of the functional impression technique used in removable partial dentures. It involves making a functional impression to capture the displaced shape of the residual ridge under load. The edentulous area is then cut out from the original master cast. The framework and functional impression are seated on the modified master cast. Stone is poured into the impression to create an altered, or corrected, cast reflecting the displaced ridge shape under load. This ensures uniform support of the denture base in the functional form of the residual ridge.
Biomimetic materials used in conservative dentistry & endodonticsTirthankar Bhaumik
This document discusses biomimetic materials used in conservative dentistry and endodontics. It begins by defining biomimetics as materials and processes that mimic nature. Glass ionomer cement is highlighted as a key biomimetic material that acts as a dentin substitute. It has properties similar to dentin, such as elastic modulus and thermal expansion coefficient, and adheres chemically to tooth structure. The document outlines various uses of glass ionomer cement in restorations, luting, liners, and as a root canal sealer. While modifications have improved some properties, its strength and wear resistance remain lower than natural dentin. Overall, the document examines how glass ionomer cement biomimically replaces lost dentin structure for
This presentation gives a brief description of the clinical features and causes of gummy smile conditions , their clinical and differential dignosis , as well as the different treatment methods that may be used to correct these problems .
This document provides an overview of endodontic surgery. It begins with a brief history of endodontic surgery dating back over 1500 years. It then discusses the definition, rationale, objectives, and indications for endodontic surgery. The document outlines the classification of endodontic surgery and describes various surgical procedures like periradicular surgery, root-end resection, and root-end filling. It provides details on surgical instruments, treatment planning considerations, and techniques for achieving profound local anesthesia. In summary, the document provides a comprehensive review of the principles and procedures involved in endodontic surgery.
This seminar includes various isolation methods which are direct and indirect with eloboration about rubber dam usage and application along with the advantages along with soft tissue isolation methods
This document discusses rotary endodontics in primary teeth. It begins with an introduction noting that canal preparation in primary teeth can be challenging but was introduced to pediatric dentistry by Barr in 2000. Rotary files are more convenient and may be better for children with behavior issues. The document then covers the development of rotary systems from the late 1800s to modern developments. It discusses features of rotary instrument design including tip design, helical angle, taper, rake angle, and movements. Common rotary systems for primary teeth like Profile are mentioned. The advantages of rotary files in pediatric cases are debridement and reduced treatment time.
This document provides information on single file systems for root canal preparation. It discusses the history of reciprocation motion and generations of rotary file systems. Specific single file systems like WaveOne and Reciproc are described in detail, including their design features and advantages. The document emphasizes that recent advances in endodontics have focused on completing root canal shaping with only one or two files to be more efficient and minimize procedural errors.
This document provides an overview of the mixed dentition period when both primary and permanent teeth are present. It defines key terms like successional and accessional teeth. The mixed dentition phase involves three transitional periods characterized by the eruption of different teeth. During the first period, the first permanent molars and incisors erupt. The relationship between primary molars impacts the occlusion. Permanent incisors overcome the space deficit through various mechanisms during the inter-transitional period before premolars and canines erupt in the second transitional period, utilizing the leeway space.
The document discusses the SLOB (Same Lingual, Opposite Buccal) technique, which is used in dental radiography. The SLOB technique involves shifting the X-ray tube head to separate superimposed structures on a radiograph. When the tube is shifted mesially, the lingual root will shift in the same direction and the buccal root will shift in the opposite direction. The SLOB technique has advantages like separating superimposed canals and structures, aiding in working length determination and identifying undiscovered canals. However, it can also cause decreased clarity and increased superimposition of structures at more oblique angles.
There are 3 types of file systems
- Flex R FIle
- Safety H Files
- Rotary File System
The invention of Flex R File was back then when Powell noticed that the straight stainless steel tips of the files could only increase the tendency of the transport or ledge and eventually to perforate curved canals at the outer wall which is a convex curvature of the canal. It was then when Powell pointed out that the reduction of tip angle could help the file to focus on the original canal and could cut the edges or the sides evenly. This modification of the tip brought in the Flex R File.
The document discusses cleaning and shaping objectives, principles, and techniques in endodontics. It aims to remove canal contents, irregularities, and obstructions while maintaining the original canal anatomy and foramen size. Cleaning is achieved through instrumentation and irrigation, assessed by debris removal and smooth canal walls. Shaping provides a continuously tapering preparation from crown to apex. Working length is 1 mm from the radiographic apex. Techniques include step-back preparation from apex to crown in phases using increasingly larger instruments supplemented by irrigation and recapitulation.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The document defines normal occlusion as the contact relationship between the teeth when the jaws are closed. It provides definitions of occlusion from Angle and Wheeler. Occlusion involves the interaction of teeth, periodontal ligaments, jaws, temporomandibular joint, muscles and nervous system. When the jaws are closed, the cusps, fossae and incisal edges of opposing teeth come into contact, making up the occlusion of the dentition. The document also describes static and dynamic occlusion, various occlusal concepts like centric relation and centric occlusion, centric contacts, and imaginary occlusal planes like the Curve of Spee and Curve of Wilson.
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
The document discusses various types of full coverage restorations for primary anterior teeth including stainless steel crowns with composite facings, composite strip crowns, polycarbonate crowns, New Millennium crowns, Kudos crowns, Pedo jacket crowns, and Artglass crowns. It describes the materials, advantages, disadvantages, and placement techniques for each type of crown. Stainless steel crowns with composite facings combine strength, durability and improved aesthetics but take longer to place. Composite strip crowns provide good aesthetics but are technique sensitive. Polycarbonate crowns and Kudos crowns are more durable alternatives that are easier to place than composite strip crowns.
Medicament's used in pulp therapy of pediatric dentistry Izhar Ali
The document discusses various medicaments used in pulp therapy for primary teeth. It describes techniques such as pulp capping, pulpotomy, and pulpectomy. Formocresol and ferric sulfate are commonly used vital pulpotomy medicaments, though concerns exist regarding formocresol's toxicity. Mineral trioxide aggregate and NuSmile NeoMTA are newer alternatives that are non-staining with good clinical success rates. Calcium hydroxide was previously used but causes resorption in primary teeth. Overall, multiple medicaments are available though studies show MTA and ferric sulfate may be favorable replacements for formocresol.
Current Concepts in Access Cavity PreparationUrvashi Tanwar
1) Traditional access cavity preparations using large round burs and Gates Glidden drills can remove excessive tooth structure and weaken teeth.
2) A more conservative access design called the "inverse funnel" or "blind funneling" is proposed to preserve the critical peri-cervical dentin through use of smaller tapered burs and partial de-roofing of the pulp chamber while still allowing for adequate debridement and obturation.
3) A study found that endodontically treated teeth with preservation of the peri-cervical dentin and pulp chamber "soffit" had greater fracture resistance compared to traditional access preparations due to reinforcement of remaining tooth structure.
The document discusses bioceramic materials used in endodontics, focusing on mineral trioxide aggregate (MTA). It provides details on the composition, properties, and clinical applications of MTA. MTA has favorable biocompatibility and bioactivity, stimulating tissue regeneration. It forms an excellent seal with good marginal adaptation and push-out bond strength to dentin. MTA is useful for pulp capping, pulpotomies, apexification, and other procedures due to its ability to encourage hard tissue formation.
The document discusses the history and advantages of using rubber dams in dentistry. It was introduced in 1864 and provides benefits such as isolating teeth, protecting tissues, and improving visibility and access. Recent advances include latex-free materials, frames with improved design for patient comfort and access, and pre-framed dams. A variety of retainers and frames exist to securely isolate teeth from saliva for endodontic procedures.
Recent advances in endodontics include improved methods for diagnosis using tools like pulse oximetry and laser Doppler flowmetry. Cone beam CT and newer apex locators provide more accurate determination of working length. Advances in instrumentation include nickel-titanium rotary files and self-adjusting files. New irrigants and devices improve cleaning and disinfection of the root canal. Regenerative endodontic procedures aim to regenerate damaged tissues through stem cell therapy and tissue engineering.
1. Etchant acid, also known as phosphoric acid, is used to condition tooth enamel prior to placing restorative materials like resins, sealants, and adhesive cements. It demineralizes the enamel, creating micro pores to achieve a strong bond between the material and tooth.
2. The acid is applied for 15-60 seconds and then rinsed thoroughly before the restorative material is placed. This micro-etching of the enamel improves retention of the restoration.
3. For ceramics, hydrofluoric acid is used which also etches the material by creating channels, allowing chemical bonding between the ceramic, silane, and resin for strong adhesion.
This document discusses inter-appointment flare ups that can occur after root canal procedures. It defines flare ups as acute exacerbations of periradicular pain or swelling requiring emergency treatment. The frequency of flare ups is reported to range from 1.4-16% in various studies. Flare ups can occur due to improper treatment techniques or insufficient time for treatment modalities. Risk factors include over instrumentation, extrusion of debris or filling material past the apex, incomplete removal of pulp tissues, and improper measurement of working length. Preventive measures include proper diagnosis, determination of working length, complete debridement, effective irrigation, and placement of intracanal medications between appointments.
This document discusses the management of endodontic pain. It defines pain and related terms like hyperalgesia. It describes the pathways of pain transmission, including the gate control theory. It discusses factors that affect a patient's pain threshold like fear. It outlines the types of dental pain and the nerves involved in transmitting pain signals. Finally, it discusses various clinical strategies for managing endodontic pain, including pulpotomy, pulpectomy, incision and drainage, and occlusal reduction. It also covers effective medical management using analgesics and anxiolytics.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
The document discusses the anatomy of the pulp cavity. It begins by introducing the importance of understanding pulp anatomy for endodontic therapy. The pulp cavity is divided into the coronal pulp chamber and radicular root canal. The pulp chamber occupies the crown and merges with the root canal. Multi-rooted teeth have a single chamber and 3 or more canals. Anatomical structures like the roof, floor, canal orifices and isthmus are described. Root canals extend from the orifice to the apical foramen. Classification systems and methods to study pulp anatomy are also outlined. Variations in shape, number of canals and pathological changes are discussed.
This document summarizes a study examining the anatomy of pulp chambers in extracted teeth. The researchers observed 500 teeth and identified consistent anatomical patterns in the location of pulp chambers and root canal orifices. They proposed several "laws" based on their observations, such as the pulp chamber always being located in the center of the tooth at the cementoenamel junction level. Understanding these anatomical patterns can help clinicians more systematically locate pulp chambers and root canal orifices during root canal procedures.
This seminar includes various isolation methods which are direct and indirect with eloboration about rubber dam usage and application along with the advantages along with soft tissue isolation methods
This document discusses rotary endodontics in primary teeth. It begins with an introduction noting that canal preparation in primary teeth can be challenging but was introduced to pediatric dentistry by Barr in 2000. Rotary files are more convenient and may be better for children with behavior issues. The document then covers the development of rotary systems from the late 1800s to modern developments. It discusses features of rotary instrument design including tip design, helical angle, taper, rake angle, and movements. Common rotary systems for primary teeth like Profile are mentioned. The advantages of rotary files in pediatric cases are debridement and reduced treatment time.
This document provides information on single file systems for root canal preparation. It discusses the history of reciprocation motion and generations of rotary file systems. Specific single file systems like WaveOne and Reciproc are described in detail, including their design features and advantages. The document emphasizes that recent advances in endodontics have focused on completing root canal shaping with only one or two files to be more efficient and minimize procedural errors.
This document provides an overview of the mixed dentition period when both primary and permanent teeth are present. It defines key terms like successional and accessional teeth. The mixed dentition phase involves three transitional periods characterized by the eruption of different teeth. During the first period, the first permanent molars and incisors erupt. The relationship between primary molars impacts the occlusion. Permanent incisors overcome the space deficit through various mechanisms during the inter-transitional period before premolars and canines erupt in the second transitional period, utilizing the leeway space.
The document discusses the SLOB (Same Lingual, Opposite Buccal) technique, which is used in dental radiography. The SLOB technique involves shifting the X-ray tube head to separate superimposed structures on a radiograph. When the tube is shifted mesially, the lingual root will shift in the same direction and the buccal root will shift in the opposite direction. The SLOB technique has advantages like separating superimposed canals and structures, aiding in working length determination and identifying undiscovered canals. However, it can also cause decreased clarity and increased superimposition of structures at more oblique angles.
There are 3 types of file systems
- Flex R FIle
- Safety H Files
- Rotary File System
The invention of Flex R File was back then when Powell noticed that the straight stainless steel tips of the files could only increase the tendency of the transport or ledge and eventually to perforate curved canals at the outer wall which is a convex curvature of the canal. It was then when Powell pointed out that the reduction of tip angle could help the file to focus on the original canal and could cut the edges or the sides evenly. This modification of the tip brought in the Flex R File.
The document discusses cleaning and shaping objectives, principles, and techniques in endodontics. It aims to remove canal contents, irregularities, and obstructions while maintaining the original canal anatomy and foramen size. Cleaning is achieved through instrumentation and irrigation, assessed by debris removal and smooth canal walls. Shaping provides a continuously tapering preparation from crown to apex. Working length is 1 mm from the radiographic apex. Techniques include step-back preparation from apex to crown in phases using increasingly larger instruments supplemented by irrigation and recapitulation.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The document defines normal occlusion as the contact relationship between the teeth when the jaws are closed. It provides definitions of occlusion from Angle and Wheeler. Occlusion involves the interaction of teeth, periodontal ligaments, jaws, temporomandibular joint, muscles and nervous system. When the jaws are closed, the cusps, fossae and incisal edges of opposing teeth come into contact, making up the occlusion of the dentition. The document also describes static and dynamic occlusion, various occlusal concepts like centric relation and centric occlusion, centric contacts, and imaginary occlusal planes like the Curve of Spee and Curve of Wilson.
This document discusses space maintainers, which are appliances used to maintain space after premature loss of primary teeth. It defines space maintainers and describes their important functions. The main causes of premature primary tooth loss are caries, trauma, ectopic eruption, and systemic disorders. Premature loss can lead to undesirable tooth movement and malocclusion. The document discusses factors that influence space closure rate and direction, as well as treatment considerations for timely space maintenance. It also outlines types of space maintainers, including fixed and removable, and their advantages and disadvantages.
The document discusses various types of full coverage restorations for primary anterior teeth including stainless steel crowns with composite facings, composite strip crowns, polycarbonate crowns, New Millennium crowns, Kudos crowns, Pedo jacket crowns, and Artglass crowns. It describes the materials, advantages, disadvantages, and placement techniques for each type of crown. Stainless steel crowns with composite facings combine strength, durability and improved aesthetics but take longer to place. Composite strip crowns provide good aesthetics but are technique sensitive. Polycarbonate crowns and Kudos crowns are more durable alternatives that are easier to place than composite strip crowns.
Medicament's used in pulp therapy of pediatric dentistry Izhar Ali
The document discusses various medicaments used in pulp therapy for primary teeth. It describes techniques such as pulp capping, pulpotomy, and pulpectomy. Formocresol and ferric sulfate are commonly used vital pulpotomy medicaments, though concerns exist regarding formocresol's toxicity. Mineral trioxide aggregate and NuSmile NeoMTA are newer alternatives that are non-staining with good clinical success rates. Calcium hydroxide was previously used but causes resorption in primary teeth. Overall, multiple medicaments are available though studies show MTA and ferric sulfate may be favorable replacements for formocresol.
Current Concepts in Access Cavity PreparationUrvashi Tanwar
1) Traditional access cavity preparations using large round burs and Gates Glidden drills can remove excessive tooth structure and weaken teeth.
2) A more conservative access design called the "inverse funnel" or "blind funneling" is proposed to preserve the critical peri-cervical dentin through use of smaller tapered burs and partial de-roofing of the pulp chamber while still allowing for adequate debridement and obturation.
3) A study found that endodontically treated teeth with preservation of the peri-cervical dentin and pulp chamber "soffit" had greater fracture resistance compared to traditional access preparations due to reinforcement of remaining tooth structure.
The document discusses bioceramic materials used in endodontics, focusing on mineral trioxide aggregate (MTA). It provides details on the composition, properties, and clinical applications of MTA. MTA has favorable biocompatibility and bioactivity, stimulating tissue regeneration. It forms an excellent seal with good marginal adaptation and push-out bond strength to dentin. MTA is useful for pulp capping, pulpotomies, apexification, and other procedures due to its ability to encourage hard tissue formation.
The document discusses the history and advantages of using rubber dams in dentistry. It was introduced in 1864 and provides benefits such as isolating teeth, protecting tissues, and improving visibility and access. Recent advances include latex-free materials, frames with improved design for patient comfort and access, and pre-framed dams. A variety of retainers and frames exist to securely isolate teeth from saliva for endodontic procedures.
Recent advances in endodontics include improved methods for diagnosis using tools like pulse oximetry and laser Doppler flowmetry. Cone beam CT and newer apex locators provide more accurate determination of working length. Advances in instrumentation include nickel-titanium rotary files and self-adjusting files. New irrigants and devices improve cleaning and disinfection of the root canal. Regenerative endodontic procedures aim to regenerate damaged tissues through stem cell therapy and tissue engineering.
1. Etchant acid, also known as phosphoric acid, is used to condition tooth enamel prior to placing restorative materials like resins, sealants, and adhesive cements. It demineralizes the enamel, creating micro pores to achieve a strong bond between the material and tooth.
2. The acid is applied for 15-60 seconds and then rinsed thoroughly before the restorative material is placed. This micro-etching of the enamel improves retention of the restoration.
3. For ceramics, hydrofluoric acid is used which also etches the material by creating channels, allowing chemical bonding between the ceramic, silane, and resin for strong adhesion.
This document discusses inter-appointment flare ups that can occur after root canal procedures. It defines flare ups as acute exacerbations of periradicular pain or swelling requiring emergency treatment. The frequency of flare ups is reported to range from 1.4-16% in various studies. Flare ups can occur due to improper treatment techniques or insufficient time for treatment modalities. Risk factors include over instrumentation, extrusion of debris or filling material past the apex, incomplete removal of pulp tissues, and improper measurement of working length. Preventive measures include proper diagnosis, determination of working length, complete debridement, effective irrigation, and placement of intracanal medications between appointments.
This document discusses the management of endodontic pain. It defines pain and related terms like hyperalgesia. It describes the pathways of pain transmission, including the gate control theory. It discusses factors that affect a patient's pain threshold like fear. It outlines the types of dental pain and the nerves involved in transmitting pain signals. Finally, it discusses various clinical strategies for managing endodontic pain, including pulpotomy, pulpectomy, incision and drainage, and occlusal reduction. It also covers effective medical management using analgesics and anxiolytics.
This document provides information about stainless steel crowns (SSCs), including their history, objectives, indications, contraindications, types, composition, clinical procedure, and references. Some key points:
- SSCs were first described in the 1950s and became commonly used in the 1960s to restore primary and permanent teeth.
- Objectives are to achieve a biologically compatible restoration that maintains tooth form and function.
- Indications include restoring teeth after pulpotomy/pulpectomy, with large/deep caries, or when 3+ surfaces need restoration.
- Clinical procedure involves evaluating occlusion, selecting correct crown size, tooth preparation to provide space and remove caries, and cementing the crown
The document discusses the anatomy of the pulp cavity. It begins by introducing the importance of understanding pulp anatomy for endodontic therapy. The pulp cavity is divided into the coronal pulp chamber and radicular root canal. The pulp chamber occupies the crown and merges with the root canal. Multi-rooted teeth have a single chamber and 3 or more canals. Anatomical structures like the roof, floor, canal orifices and isthmus are described. Root canals extend from the orifice to the apical foramen. Classification systems and methods to study pulp anatomy are also outlined. Variations in shape, number of canals and pathological changes are discussed.
This document summarizes a study examining the anatomy of pulp chambers in extracted teeth. The researchers observed 500 teeth and identified consistent anatomical patterns in the location of pulp chambers and root canal orifices. They proposed several "laws" based on their observations, such as the pulp chamber always being located in the center of the tooth at the cementoenamel junction level. Understanding these anatomical patterns can help clinicians more systematically locate pulp chambers and root canal orifices during root canal procedures.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The dental pulp originates from cranial neural crest cells that migrate into the developing tooth germ. During tooth development, these cells form the dental papilla which becomes the dental pulp. The pulp contains odontoblasts, fibroblasts, undifferentiated mesenchymal cells, and macrophages. It has a cell-rich zone containing blood vessels and a cell-free zone near the odontoblasts. The pulp shapes change from development to maturity as the root forms and remodels. It is divided into coronal and radicular portions, connected through the apical foramen.
Este documento describe las normas y leyes anatómicas para la preparación de cavidades de acceso en molares superiores e inferiores para tratamiento endodóntico. Explica la importancia de eliminar toda la caries y estructura dental dañada, y de acceder directamente a los conductos radiculares siguiendo las líneas anatómicas. También describe las características anatómicas típicas de los diferentes molares y el instrumental requerido para una preparación de acceso exitosa.
The document discusses the anatomy and terminology related to the pulp space within teeth. It describes the different components that make up the pulp space, including the pulp chamber, pulp horns, root canal, lateral canals, apical foramen and others. It also discusses variations in root canal morphology, histology of the pulp, and functions of the pulp tissue.
This document discusses root canal morphology and access cavity preparation. It begins with an introduction discussing the objectives of root canal treatment and the importance of understanding root canal anatomy. It then covers topics like root canal classification systems, anatomy of the apical root, accessory canals, canal isthmuses, root canal curvatures, and guidelines for cavity preparation. The document provides detailed information on root canal anatomy and considerations for access cavity preparation.
Knowledge of root and root canal morphology is a prerequisite for effective non-surgical and surgical endodontic treatments. The external and internal morphological features of roots are variable and complex, and several classifications have been proposed to define the various types of canal configurations that occur commonly. More recently, improvements in non-destructive digital image systems, such as cone-beam and micro-computed tomography, as well as the use of magnification in clinical practice, have increased the number of reports on complex root canal anatomy. Importantly, using
these newer techniques, it has become apparent that it is not possible to classify many root canal configurations using the existing systems. The purpose of this article is to introduce a new classification system that can be adapted to categorize root and root canal configurations in an accurate, simple and reliable manner that can be used in research, clinical practice and training.
This document discusses the anatomy of the dental pulp. It begins by describing the development of the pulp from the dental papilla and how it becomes surrounded by dentin. It then describes the anatomy of the coronal and radicular pulp, including differences between primary and permanent teeth. Key aspects covered include pulp chambers, horns, and variations such as accessory canals and apical anatomy including the apical foramen. Age-related changes are discussed as well as clinical considerations for negotiating variations.
Endodontics deals with diseases of the dental pulp, which is made of loose connective tissue inside the root canals. The number of canals correlates to the number of tooth roots. The pulp provides nutrients, sensation, and forms secondary dentin for protection. Accessory canals can branch off from the main canal. Proper access cavity preparation is important to allow straight-line access to the canals and apical foramen. Irrigation serves to lubricate, dissolve pulp, wash out debris, and disinfect canals using solutions like sodium hypochlorite and EDTA. New technologies like EndoVac and EndoActivator improve irrigation.
The document discusses access cavity preparation for endodontic treatment. It provides guidelines for preparing access cavities, including removing caries and restorations, locating all canal orifices, and achieving straight line access to the canals. Specific steps are outlined for preparing access cavities in anterior and posterior teeth, including maxillary and mandibular molars as well as maxillary central incisors. The goal of access cavity preparation is to allow for thorough cleaning, shaping, and filling of the root canal system.
El documento proporciona información sobre los premolares y molares posteriores permanentes superiores e inferiores. Describe las características de la corona, raíces y erupción de cada diente. Los primeros premolares superiores tienen dos raíces, mientras que los inferiores generalmente tienen una sola raíz. El primer molar superior tiene tres raíces y el inferior tiene dos raíces.
This document discusses guidelines and principles for locating canals and preparing access cavities for endodontic treatment. It covers:
- The three main factors for endodontic success: cleaning and shaping, disinfection, and obturation.
- Preparing the access cavity is an important first step to identify all root canals so they can be treated.
- General principles for access cavity preparation include doing no harm, confirming diagnosis, and allowing straight-line access.
- Techniques for locating canals using anatomical landmarks like the cementoenamel junction and developmental root lines are described.
- Armamentarium and steps for access cavity preparation in different tooth types are outlined.
anatomy of pulp cavity and access opening.pptxadityabhagat62
The document describes the anatomy of the pulp cavity and access openings for various teeth. It discusses the pulp cavity, which consists of the pulp chamber and root canals. The pulp chamber roof and floor are described along with the location of canal orifices. Guidelines are provided for access cavity preparation, including removal of carious tooth structure and de-roofing the pulp chamber. The document then reviews the anatomy and access openings for various individual teeth.
The document discusses the anatomy and root canal morphology of the mandibular second molar tooth. It notes that this tooth typically has two roots, though it can sometimes have one or three roots. The pulp chamber is generally smaller than the first molar with root canals that are smaller and closer together. There is a higher incidence of C-shaped canals in the second molar compared to other teeth. The document outlines guidelines for accessing the pulp chamber and provides examples of common errors in access opening preparation. It also presents cases of anatomical variations like extra roots or canals that may be encountered during root canal treatment of the mandibular second molar.
The document discusses the anatomy of pulp cavities. It describes the origin, functions, and components of the dental pulp. The pulp consists of the pulp chamber within the crown and pulp canals within the roots. The size and shape of the pulp cavity varies depending on the tooth type and age. Knowledge of pulp cavity anatomy is important for operative procedures, endodontic treatment, and to prevent unnecessary encroachment on the pulp. The document then examines the specific anatomy of different tooth types.
This document discusses osseous surgery and the treatment of bone defects caused by periodontitis. It begins with an overview of normal bone topography and how bone loss from periodontal disease can result in abnormal architectures like interproximal craters and angular bony defects. The rationale for surgical correction of these bone defects is explained, along with the objectives, techniques, and healing process of osseous surgery. Specific challenges like furcation invasions are also addressed. The goal of osseous surgery is to reshape damaged bone in order to reduce pockets and allow for periodontal regeneration.
This document discusses the anatomy of root canals and related structures. It begins with an introduction and overview, then discusses topics like pulp chamber anatomy, root canal classification systems, the apical foramen, accessory foramina, apical constriction, isthmuses, C-shaped canals, and anatomy of individual teeth. It also touches on developmental disturbances and references other research. The overall document provides an in-depth look at root canal anatomy, variations, related structures, and classification systems.
This document discusses guidelines for access cavity preparation in endodontic treatment, including in special situations. It begins by outlining the objectives of achieving straight line access to canals and removing caries/defective restorations. Principles of access preparation include following the internal anatomy and removing remaining caries. Specific guidelines are provided for various tooth types, and locating additional canals like the MB2 in maxillary molars is discussed. Aids like microscopes and ultrasonic tips can help in complex cases.
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The document outlines six laws of access cavity preparation:
1. The law of centrality states that the floor of the pulp chamber is located in the center of the tooth at the cementoenamel junction level.
2. The law of the cementoenamel junction notes that the distance from the crown to the pulp chamber wall is consistent around the tooth at this junction.
3. The laws of concentricity and symmetry describe the positioning of pulp chamber walls and canal orifices relative to external tooth features.
4. The law of color change specifies that the floor is darker than surrounding walls.
5. The law of orifice location indicates orifices are found at wall-floor junction
Radiography is essential for endodontic diagnosis, treatment, and evaluation of treatment outcomes. It helps determine pulpal and periapical pathology, root and canal morphology, working lengths, location of missed canals, and quality of obturation. Key radiographic views include diagnostic, working length, post-treatment, and recall films. Diagnostic films aim to visualize 3-4mm beyond the apex to identify lesions. Angulation and tube shift techniques help differentiate superimposed structures. Features like lamina dura continuity, lesion borders, density and effects on adjacent structures aid diagnosis. Newer technologies include digital radiography and cone beam CT for improved visualization of complex anatomy.
The document provides guidance on properly accessing the pulp chamber and locating root canal orifices through a systematic method. It begins by outlining key concepts like visualizing the pulp complex as a continuum from the pulp horns to the apical foramina. It then details a 4-step process for access: 1) pre-access analysis using laws of centrality and concentricity to determine entry point, 2) removing roof completely to reveal floor, 3) using laws of symmetry and color change to locate orifices, 4) addressing problems like excessive bleeding or calcification. The goal is to create a complete access that allows visualization of the floor-wall junction around the entire chamber to locate all root canals.
Internal anatomy of pulp space. Includes history, development of pulp, classification of the root canal, isthmus, root canal ramifications, regressive changes, apical root anatomy, variations in pulpal anatomy, methods of determining anatomy, pulp space anatomy of permanent teeth.
This document discusses root canal morphology and its relationship to endodontic procedures. It begins by explaining that the root canal system takes on numerous complex configurations that are not always evident on radiographs. A thorough understanding of root canal anatomy is important for successful endodontic treatment. The document then describes various anatomical structures like accessory canals, lateral canals, furcation canals and apical deltas. It discusses how tools like operating microscopes and multiple angled radiographs can help visualize complex root canal anatomies. Finally, it summarizes research on the varying root canal configurations that have been observed in different tooth types.
Relation ofaccess cavity design to the canal orificeAsif mannan
The document discusses the importance of proper access cavity preparation in lower first molars for successful root canal treatment. It outlines the anatomy of the lower first molar, including the typical root and canal morphology. The objectives of an ideal access are to locate all root canal orifices and maintain tooth structure. Laws of orifice location are described to help practitioners identify canal openings based on anatomical landmarks of the pulp chamber floor and walls. Common problems in access preparation and visualizing the floor are addressed, along with remedies to overcome each issue.
Clinical Approach of a Tooth with Radix Entomolaris and Five Root CanalsAbu-Hussein Muhamad
The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and technically challenging. Radix Entomolaris (RE) is one such aberration where an extra root is present on the distolingual aspect of mandibular first molar . This article presents a case report of mandibular first molar with five root canals.
This document discusses the complex anatomy of teeth, with a focus on the anatomy of the root apex. It provides background on early classification systems for tooth anatomy and describes various anatomical features of the root apex, including the apical constriction, apical foramen, types of apical constrictions, root apex shapes, canal morphologies, and root canal classifications. Understanding the detailed anatomy and variations of the root apex is important for effective endodontic treatment and procedures.
The document discusses root canal anatomy, terminology, morphology, and access cavity preparation for anterior teeth. It describes the typical root canal configuration starting at the orifice and ending at the foramen, as well as common variations. Key steps for access cavity preparation include understanding internal anatomy, evaluating the cementoenamel junction and occlusal anatomy, removing caries and defective restorations, and achieving straight-line access to locate all
This document provides definitions and descriptions of the anatomical structures that make up the alveolar process. It defines the alveolar process as the bone of the jaws that contains the teeth. It then describes in detail the developmental process, macro-anatomical structure including cortical plates, spongy bone, and alveolar bone, and age-related changes of the alveolar process. Finally, it discusses some clinical considerations regarding the alveolar process related to x-rays, orthodontics, and tooth extractions.
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2. 6 Krasner and Rankow Journal of Endodontics
FIG 2. Cut specimen of a mandibular molar showing the concentricity
of the pulp-chamber walls to the external tooth surface at the CEJ.
FIG 1. Cut specimen of a mandibular molar showing the centrality of
the pulp chamber.
concentric to the external surface of the tooth at the level of the
CEJ (Figs. 1–3).
Law of the CEJ: the CEJ is the most consistent, repeatable land-
mark for locating the position of the pulp chamber.
Relationships on the Pulp-chamber Floor
The following observations were noted relative to all teeth:
1. The floor of pulp chamber is always a darker color than the
surrounding dentinal walls (Fig. 4A).
2. This color difference creates a distinct junction where the walls
and the floor of the pulp chamber meet (Figs. 4B and 5).
3. The orifices of the root canals are always located at the junction
of the walls and floor (Figs. 5 and 6).
4. The orifices of the root canals are located at the angles in the
floor wall junction [Fig. 6 (A and B)].
5. The orifices lay at the terminus of developmental root fusion
lines, if present [Fig. 7 (A–C)].
6. The developmental root fusion lines are darker than the floor
color (Fig. 7A).
7. Reparative dentin or calcifications are lighter than the pulp- FIG 3. Cut specimen of a mandibular molar showing the equality of
chamber floor and often obscure it and the orifices (Fig. 8). the distance of the pulp chamber walls from the external root sur-
The following observations were noted relative to all teeth face (arrows).
except maxillary molars:
1. If a line is drawn in a mesial-distal direction across the center of 2. If a line is drawn in a mesial-distal direction across the center of
the floor of the pulp chamber, the orifices of the canals on either the floor of the pulp chamber, the orifices of the canals on either
side of the line are equidistant [Fig. 9 (A and B)]. side are perpendicular to it [Fig. 9 (C and D)].
3. Vol. 30, No. 1, January 2004 Pulp–Chamber-floor Anatomy 7
FIG 5. Cut specimen showing the orifices (OL) located at the junction
of the floor and walls (FWJ).
Law of symmetry 2: except for the maxillary molars, the orifices
of the canals lie on a line perpendicular to a line drawn in a
mesial-distal direction across the center of the floor of the pulp
chamber [Fig. 9 (C and D)].
Law of Color Change: the color of the pulp-chamber floor is
always darker than the walls (Fig. 4A).
Law of orifice location 1: the orifices of the root canals are always
located at the junction of the walls and the floor (Fig. 5).
Law of orifice location 2: the orifices of the root canals are located
at the angles in the floor-wall junction (Figs. 5 and 6A).
Law of orifice location 3: the orifices of the root canals are located
at the terminus of the root developmental fusion lines (Fig. 7A).
A summation of all of the laws and rules are shown in [Fig. 10
(A and B)].
DISCUSSION
FIG 4. (A) Cut specimen showing the dark chamber floor (FI). (B) Cut Definite patterns and relationships of the pulp chamber and on
specimen showing the junction of the light walls and the dark floor the pulp-chamber floor were observed. From these observations,
(FWJ). specific laws have been proposed to help the clinician more sys-
tematically locate pulp chambers and the number and position of
These observations were consistent enough that several ana-
root-canal orifices on the pulp-chamber floor.
tomic laws regarding the pulp chamber floor can now be proposed:
Most practitioners begin root-canal treatment with preconceived
Law of symmetry 1: except for maxillary molars, the orifices of the ideas about the anatomy and position of pulp chambers and roots
canals are equidistant from a line drawn in a mesial distal canals. These ideas are based on stylized pictures of virgin teeth
direction through the pulp-chamber floor [Fig. 9 (A and B)]. presented in textbooks. Access to the pulp chamber is usually
4. 8 Krasner and Rankow Journal of Endodontics
crown). Using this artificial anatomy as a guide to where to begin
accessing the tooth may lead to perforation in a lateral direction. In
this study, the CEJ was the most consistent anatomic landmark
observed. Regardless of how much clinical crown was lost or how
extensive the crown restoration, the CEJ could always be observed.
Given the observation that the CEJ is the most reliable guide for
access, we encourage the clinician to ignore the clinical crown as
a guide in directing access, and instead, recommend the use of the
CEJ as the ultimate “Northstar” for locating the pulp chamber.
Knowledge of the law of centrality will help prevent crown
perforations in a lateral direction. Because the pulp chamber is
always centrally located at the level of the CEJ, the operator can
use the CEJ as a circular target regardless of how nonanatomic the
clinical crown or restoration may be. Even if the crown sits at an
obtuse angle to the root, the CEJ can still be a reliable landmark for
locating the pulp chamber.
The law of concentricity will help the clinician to extend his
access properly. When the clinician observes a bulge of the CEJ to
the mesiobuccal (Fig. 11), either visually or by probing, he will
then know that the pulp chamber also will extend in that direction.
If the tooth is narrow mesiodistally, then the clinician will know
that the pulp chamber will be narrow mesiodistally (Fig. 12).
This study has resulted in observations regarding the pulp-
chamber floor that have not been previously described. These
observations were correlated to propose laws that can aid practi-
tioners in determining the number and position of orifices of root
canals of any tooth. Use of these laws takes the guesswork out of
the task of finding canals. The only requirement for proper use is
that the access to the chamber be completed so that the entire floor
of the pulp chamber is visible without any overlying obstruction.
The law of color change provides guidance to determine when
the access is complete. Proper access is complete only when the
entire pulp-chamber floor can be visualized. The operator knows
that he has completed the access when he can delineate the junction
of the pulp-chamber floor and the walls 360 degrees around the
chamber floor (Fig. 13). Because a distinct light-dark junction is
always present, if it is not seen in one portion of the chamber floor,
the operator knows that additional overlying structure must be
removed. This structure could be restorative material, reparative
dentin, or even overlying pulp chamber roof. This interference with
the complete visualization of the walls can be seen in Figs. 8 and
14.
After this junction is clearly seen, all of the laws of symmetry
and orifice location can be used to locate the exact position and
number of orifices. The laws of symmetry can be invaluable in
determining the exact position of canals and often indicate the
presence of an additional unexpected canal. Look at the position of
the orifices on the pulp chamber floor in [Fig. 15 (A and B)].
Knowledge of the laws of symmetry 1 and 2 immediately indicates
the presence of a fourth canal. Indeed, it not only implies the
presence of a fourth canal but exactly where it is located [Fig. 15
(C and D)].
The law of orifice locations 1 and 2 can be used to identify the
FIG 6. (A) Cut specimen showing the orifices located (OL) at the number and position of the root-canal orifices of the tooth. Because
angles in the chamber floor and floor-wall junction (FWJ). (B) Dia- all of the orifices can only be located along the floor-wall junction,
gram of mandibular molar showing orifice location at the angles of black dots, indentations, or white dots that are observed anywhere
the chamber floor and floor-wall junction.
else (e.g. the chamber walls or in the dark chamber floor) must be
ignored to avoid possible perforation. The law of orifice location
recommended based on this ideal anatomy and the clinician works 2 can help to focus on the precise location of the orifices. The
from “outside-in.” However, after restoration of a tooth, the oc- vertices or angles of the geometric shape of the dark chamber floor
clusal anatomy may have no relevance to the position of the will specifically identify the position of the orifice. If the canal is
underlying pulp chamber (e.g. that of a porcelain-fused-to-gold calcified, then this position at the vertex will indicate with certainty
5. Vol. 30, No. 1, January 2004 Pulp–Chamber-floor Anatomy 9
FIG 7. (A) Cut specimen showing the developmental root fusion lines (DRFL) and the floor-wall junction (FWJ). (B) Developmental root fusion
lines of a mandibular molar. (C) Developmental root fusion lines of a maxillary molar.
where the operator should begin to penetrate with his bur to presence and location of second canals in mesiobuccal roots of
remove reparative dentin from the upper portion of the canal (Fig. maxillary molars [Fig. 16 (A and B)]. Look at the floor anatomy in
15A,E). The law of orifice locations 1 and 2, in conjunction with Fig. 17A. Along the floor-wall junction, there is an angle in the
the law of color change, is often the only reliable indicator of the floor geometry between the mesiobuccal and palatal orifices. The
6. 10 Krasner and Rankow Journal of Endodontics
second and third molars were especially deviant. Approximately
5% of these teeth most often showed a different anatomy. This
anatomy has often been described in the literature and has been
observed clinically as a C-shaped canal. Even in these teeth,
however, the laws of color change and orifice location 1 apply. The
laws of symmetry 1 and 2 and orifice locations 2 and 3, however,
are not observed in them.
The ramifications and use of these laws are far ranging and man-
ifold. A specific technique has been developed using the laws to
identify the number and position of root-canal orifices in teeth and
especially those in heavily calcified pulp chambers. This technique
will be discussed in a subsequent article.
SUMMARY
The cause of most endodontic failures is inadequate biome-
chanical instrumentation of the root-canal system. This can
result from inadequate knowledge of root-canal anatomy. Be-
cause one can never know before treatment begins how many
root canals are in a tooth, only a systematic knowledge of
pulp– chamber-floor anatomy can provide greater certainty
about the total number of root canals in a particular tooth.
Knowing the average number of root canals in a tooth has
limited clinical relevance to the specific tooth being treated. If
one or more of the root canals remains undiscovered, failure
potential increases. Therefore, the only way to provide the best
FIG 8. Cut specimen of a mandibular molar showing light colored
reparative dentin on chamber floor. environment for success is to establish the full extent of the
root-canal system. This study showed that consistent patterns of
anatomy of both the chamber and the pulp-chamber floor exist.
These consistent patterns were analyzed and from them laws
laws of orifice locations 1 and 2 dictate the presence of a mesio-
were proposed. These laws can be used to help practitioners
palatal orifice (Fig. 17B). This orifice can be any distance from
identify the total number of canals in any tooth and their
either orifice but must be along this junction line.
specific orifice location on the pulp-chamber floor.
The laws of symmetry 1 and 2, color change, orifice locations
With the proposal of a systematic anatomic approach to pulp
1 and 2 can be applied to any tooth. They are especially valuable
chamber and root– canal-orifice location, the practice of endodon-
when unexpected or unusual anatomy is present. Notice the dia-
tics can now be based on fundamental surgical anatomic principles.
grammatic representation of a chamber floor of a maxillary second
As in other medical specialties, knowledge of basic concepts such
premolar (Fig. 18A). Knowledge of the chamber-floor-anatomy
as these laws is more important than the tools for measurement.
laws immediately leads the observer to realize that there are three
With this anatomic basis, the use of supplementary instruments,
canals in this tooth (Fig. 18B).
such as microscopes, can now be rationally used, not as gimmicks,
Another example of the value of chamber–floor-anatomy
but as valuable tools for conducting treatment.
knowledge can be seen in Fig. 19A, which shows a mandibular
molar that has been sectioned at the CEJ. Using the laws of Drs. Krasner and Rankow are professors, Temple University, School of
chamber-floor anatomy, the observer is guided to realize that Dentistry
there are only two orifices in this tooth. Their positions are The authors thank all of our graduate students for their never-ending
indicated in Fig. 19B. interest in this subject, Dr. Peter Friedman for editing help, and Mary Ferrell for
The relationships that we observed occurred with very high inspiring us to complete this article.
frequency. Over 95% of the specimens we observed demonstrated Address requests for reprints to Dr. Paul Krasner, 18 S. Roland Street, Pottstown,
all of the laws. There were, however, exceptions. Mandibular PA 19464.
7. Vol. 30, No. 1, January 2004 Pulp–Chamber-floor Anatomy 11
FIG 9. (A) Cut specimen of mandibular molar showing equidistance of orifices from mesiodistal line. (B) Mandibular molar showing equidistance
of orifices from mesiodistal line. (C) Cut specimen of mandibular molar showing orifices perpendicular to mesiodistal line. (D) Mandibular molar
showing orifices perpendicular to mesiodistal line.
8. 12 Krasner and Rankow Journal of Endodontics
FIG 11. Cut specimen showing CEJ bulge (CB) with concentric
chamber wall.
FIG 10. (A) Cut specimen showing the laws of symmetry 1 and 2 and
orifice locations 1, 2, and 3. (B) Laws of symmetry 1 and 2 and orifice
locations 1, 2, and 3.
10. 14 Krasner and Rankow Journal of Endodontics
FIG 15. (A) Cut specimen with pulp– chamber-floor anatomy that, through the laws of symmetry and orifice location, indicates the presence of
a fourth canal. (B) Pulp– chamber-floor anatomy, which, through the laws of symmetry and orifice location, indicates the presence of a fourth
canal. (C) Cut specimen of a mandibular molar that shows the presence and position of a fourth canal. (D) Mandibular molar that shows the
presence and position of a fourth canal. (E) Cut specimen showing floor-wall junction (FWJ) and the lack of observation of distinct floor-wall
junction (NFWJ). (F) Cut specimen showing use of law of symmetry (arrows) to show where to begin to remove overlying roof or reparative
dentin.
11. Vol. 30, No. 1, January 2004 Pulp–Chamber-floor Anatomy 15
FIG 17. (A) Cut specimen showing position of a mesiopalatal orifice
FIG 16. (A) Cut specimen of maxillary molar that uses laws of orifice (MPC) after the laws of orifice location. (B) Position of a mesiopalatal
location to show potential sites of calcified canals (PCC) and orifice orifice (MPC) after the laws of orifice location.
location (OL). (B) Maxillary molar that uses laws of orifice location to
show potential sites of calcified canals (PCC).
12. 16 Krasner and Rankow Journal of Endodontics
FIG 18. (A) Premolar access and pulp-chamber floor with an anatomy
that, using the laws of symmetry and orifice location, shows the
presence of a third canal. (B) Premolar access and pulp chamber
that show the presence and position of a third canal.
FIG 19. (A) Cut specimen of a mandibular molar that, using the laws
of symmetry and orifice location, shows the presence of two ori-
fices. (B) Mandibular molar that, using the laws of symmetry and
orifice location, shows the presence of two orifices.